Transderm Scop
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KIDNEY DISEASES: BLADDER STONES
The kidney shares in the troubles of the other parts of the body. Tuberculosis, which attacks any part of the body, makes no exception of the kidney. But strangest of all are the tricks played here by some minute pieces of tissue in the neck.
The thyroid gland snugs itself about the windpipe in the front of the neck. In the tissues rather closely attached to it are usually four tiny seeds of tissue, one quarter inch in diameter and difficult to see even when they are looked for by a surgeon. These are parathyroid glands. Their big function seems to be to regulate the calcium and phosphorus in the blood. Occasionally tumors grow in these glands causing an overdose of their secretion. Then the proportion of calcium in the blood is high. The calcium is removed from the bones. One of the places where it is deposited is the urine.
Kidney or bladder stones are formed largely of calcium. Therefore when a patient is afflicted with many of these it is advisable that the doctor should suspect hyperparathyroidism; that is, increase in the activity of the parathyroids. It does not, however, necessarily follow that deposits of calcium in the body are due to this trouble. Any dead, dying, or chronically inflamed tissue may have calcium deposits. The normal kidney puts out water and solid matter which is soluble in it. If there is something abnormal interfering with the flow of urine, infection may occur here; then some of the solid matter may be precipitated, and a stone begins to form. It seems as though this might be the origin of most urinary stones.
The mere presence of a stone in the kidney may not necessarily cause symptoms. Usually these occur when the stone moves. In fact the severe symptoms most often occur when the stone gets into the ureter, the small tube leading to the bladder, and small gravel-like stones here may cause excruciating pains. Fortunately as an aid to diagnosis they are associated with blood in the urine in most cases. If the stone is on the right, the signs and symptoms may suggest acute appendicitis and produce sympathetic suffering in the breast of the surgeon who has to solve the problem.
One of the most famous historical operations before anesthesia and asepsis was “cutting for stone.” Stones in the bladder were what was meant. Time was all important, as the patient was writhing in agony; and the great surgeons were sort of sleight-of-hand performers who with a few accurate slashes removed the stone in about the time it takes to tell about it. Henry Jacob Bigelow, of Boston, made a great advance from this custom in the latter part of the nineteenth century when he invented his “lithotrite.” This instrument was introduced into the bladder, the stone was found by feeling, crushed, the small pieces washed out, and the procedure repeated until all the stone was gone. Dr. Bigelow was justly proud of his apparatus, which he handled with great skill, but it appears as cumbersome to us now as an old-fashioned spinning wheel.
Despite Dr. Bigelow’s parental pride, it is safe to say that his admiration would be unbounded could he see a modern urologist locate the stone by X-ray, deftly bring it down by a cystoscope, or do a neat careful operation, able to see just what he is doing and to have his patient healed and well in a few weeks.
*36/276/5*
